頁籤選單縮合
題 名 | The Timing of Vertebroplasty in the Treatment of Painful Osteoporotic Vertebral Compression Fractures=施行經皮脊椎體成形術治療骨質疏鬆性脊椎壓迫性骨折之時機探討 |
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作 者 | 李協興; 趙國華; 王世杰; 吳興盛; | 書刊名 | Journal of Medical Sciences |
卷 期 | 24:3 2004.06[民93.06] |
頁 次 | 頁129-134 |
分類號 | 416.61 |
關鍵詞 | 經皮脊椎體成形術; 骨質疏鬆性脊椎壓迫性骨折; Methylmethacrylate; Osteoporosis; Vertebral compression fracture; Vertebroplasty; |
語 文 | 英文(English) |
英文摘要 | Background: Percutaneous vertebroplasty is a new technique that can resolve the pain and improve the function of fractured vertebrae. The purpose of this study was to determine the optimal timing to perform this technique. Methods: Sixty-five patients with 78 osteoporotic vertebral compression fractures treated with percutaneous vertebroplasty over a 15-month period were included in the study. The patients were stratified into 3 groups (acute, subacute, and chronic) according to the interval between the onset of back pain and the date of surgery. The functional outcomes were evaluated using the modified scoring system developed by the Japanese Orthopedic Association, and the recovery rates were analyzed. Results: Significant pain relief was noted for 95%, 88%, and 68% of the acute, subacute, and chronic patients, respectively. The recovery rates in these 3 groups were 92%, 84%, and 62%. Statistical comparison of these recovery rates revealed no significant difference between the acute and subacute groups (p=0.062); however, significance was demonstrated between the chronic and acute/subacute groups (p=0.001 and 0.01). There were 2 patients in the acute group who sustained cement leakage into the paravertebral soft tissue and the disc space as determined by post-operative radiography. Conclusions: The complication risk of percutaneous transpedicular vertebroplasty is minimal where patient selection is appropriate, while the potential benefits are significant. This study suggests that the best candidate for percutaneous vertebroplasty is the subacute group (interval 1-3 months) in which satisfactory results can be achieved and the risk of cement leakage remains lower than that of the acute group. |
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